Study of the pancratic Beta cell function in the prediabetic subjects, especially in the non-diabetic co-twins of identical diabetic twins.

通过问卷调查收集了患有糖尿病的同卵双胞胎给日本糖尿病学会的会员。通过口服葡萄糖耐量试验检查这对双胞胎是否患有糖尿病。用放射免疫测定系统测定OGTT期间的血清胰岛素反应。已经收集了86对同卵双胞胎。76对双胞胎被诊断患有糖尿病。在60对双胞胎中，每对双胞胎都患有糖尿病。在15对双胞胎中，一个患有糖尿病，另一个没有糖尿病。16名患有糖尿病的双胞胎被认为是糖尿病前期或有糖尿病易感性的受试者。在16对糖尿病前期双胞胎中，15对双胞胎的口服葡萄糖耐量试验出现了边缘性异常，只有1对双胞胎的耐量正常。在这些双胞胎中，胰岛素反应是不均匀的。葡萄糖耐量试验显示胰岛素反应曲线正常3例，延迟反应9例，低胰岛素反应4例。在早期胰岛素反应方面，同卵双胞胎组30 min时胰岛素生成指数较低，胰岛素生成指数平均值为0.33+-0.17,87%的病例属于低反应组（胰岛素生成指数和或1低于0.5）。这些双胞胎的总胰岛素反应（GTT期间胰岛素值的总和除以血浆葡萄糖值的总和）与对照组没有差异。在三个病例中，对胰岛素反应进行了纵向跟踪。胰岛素反应在随访初期接近正常，随着糖耐量的下降，胰岛素反应逐渐向上述异常模式转变。综上所述，糖尿病易感性受试者在口服葡萄糖刺激试验早期胰岛素反应较低。但是不太可能把这种异常定义为遗传倾向。(1)糖尿病(2)双胞胎研究(3)遗传学(4)胰岛素反应(5)前驱糖尿病(6)NIDDM(7)胰岛素原指数较低

The identical twins with diabetes were collected by questionnaire to the members of The Japan Diabetes Society. The both of twins were examined whether having diabetes or not by the oral glucose tolerance tests. Serum insulin response during OGTT was measured by a radioimmunoassay system.Eighty six pairs of the identical twins have been coolected. Seventy six twins were diagnosed as having diabetes. In sixty pairs, both of each twin pair had diabetes. In fifiteen pairs, one twin had diabetes and the co-twin was nondiabetic. Sixteen non-diabaetic co-twins having the diabetic twin-sibling were considered as prediabetics or subjects with diabetic predisposition. In 16 prediabetic co-twins, 15 co-twins showed borderline abnormality on oral glucose tolerance test and only one co-twin showed normal tolerance. In these co-twins, insulin response was not homogenous. Three cases showed normal insulin response curve, 9 cases showed delayed response and 4 cases showed low insulin response through … More glucose tolerance test. As to the early insulin response, insulinogenic index at 30 min. was low in the co-twins group, The mean value of the insulinogenic index was 0.33+-0.17 and 87% of the cases belonged to the low responder group (insulinogenic index and or 1 below 0.5). The total insulin response in these co-twins (the sum of insulin values during GTT divided by the sum of plasma glucose values) did not differ from the control group. In three cases, the insulin response was followed longitudinally. Insulin response was near normal in the early period of follow-up intervals and it shifted to the abnormal pattern as mentioned above gradually, according to the decline of glucose tolerance. In summary, the subjects with the diabetic predisposition had the low insulin response in the early phase of oral glucose stimulation test. But it is unlikely to define such an abnoramaily as the genetic predisposition.10. (1) diabetes mellitus (2) twin study (3) genetics (4) insulin response (5) prediabetes (6) NIDDM (7) insulinogenic index Less